Do claims for tinnitus supplements ring true?

For millions of people, the quietest room is never quiet enough. Even when surrounded by silence, they can hear a ringing or buzzing in their ears that drives them to distraction. The sound is called tinnitus, and sufferers — often people with hearing trouble thanks to advanced age or loud sounds — are willing to go to great lengths to stop the noise.

Some plead with their doctors to cut their hearing nerves completely, but even this drastic measure won't help. The few patients who have had the procedure could still hear their tinnitus — and nothing else.

Tinnitus can sometimes be treated with electronic masking devices that help obscure the sound. And some patients find relief from cognitive behavioral therapy, a type of counseling that can encourage people to think about things other than their tinnitus.

These approaches don't work for everyone, and they can be expensive, so it's no wonder that many people end up looking for tinnitus relief in a pill. Options include Quietus, a homeopathic supplement advertised on radio and television. (Not to be confused with Quietus, the fictional suicide pill in the 2006 science fiction film "Children of Men.") A bottle of 60 tablets, a one-month supply if taken twice daily as directed, costs $99. The website doesn't list any ingredients, and Preval Group, the PR firm that represents Quietus, didn't respond to requests for information. A man who answered the phone for the Quietus customer service hotline would say only that the product contains a "powerful lineup of ingredients."

Another option is Tinnitus Relief Formula from Arches Health Products. Each capsule contains 120 milligrams of ginkgo biloba along with zinc and garlic extract. Users are instructed to take two capsules twice daily. If you order from the company website, you can buy a bottle of 100 capsules for $35. Arches also sells a "combo pack," which includes four bottles of Tinnitus Relief Formula, a bottle of a "high potency B vitamin complex" and a bottle of vitamin B-12. The pack, good for a three-month supply when taken as directed, costs about $150.

Claims: The TV ad for Quietus says that the product "has helped thousands of people with tinnitus" and will "stop the ringing fast." The ad doesn't explain how Quietus is supposed to work, although the website does clarify that it was "created by a rock drummer" to treat his tinnitus.

The website for Tinnitus Relief Formula says "if you do only one thing for your tinnitus … this is it!" The site also says that "many individuals will experience a reduction in symptoms in four weeks."

The bottom line: A lot of patients ask if Quietus or other tinnitus supplements are worth a try, says audiologist Jeff Carroll, director of the Tinnitus Treatment Center at UC Irvine. "If I thought that these products worked, I would offer them in my clinic in a heartbeat," he says. But to his mind, there's no solid evidence that the supplements are of use. "We don't recommend them."

Quietus is a homeopathic treatment, which means the tablets will contain only the slightest trace of active ingredients, whatever they are. Homeopathy has never been carefully studied for tinnitus, but the National Center for Complementary and Alternative Medicine notes that the homeopathic approach to medicine is "controversial" because its "key concepts are not consistent with established laws of science."

Unlike homeopathy, ginkgo really has been put to the scientific test — with mixed results. Some clinical trials have found that the herb, believed to improve circulation to the inner ear, can quiet the noise in some patients. For example, a 1986 French study of 103 patients who had recently developed tinnitus found that half of the subjects reported relief after taking a ginkgo supplement for 70 days. Other studies, including a 2001study of more than 1,100 tinnitus sufferers in England, have found that ginkgo didn't work any better than a placebo or sugar pill. The German Commission E, a generally respected source on herbal remedies, has concluded that taking 240 mg of ginkgo twice a day can be helpful for tinnitus.

Even believers in ginkgo don't claim that it works for everyone. "We know that there are no cures," says Dr. Michael Seidman, director of the Division of Otologic-Neurotolgic Surgery in the Department of Otolaryngology- Head & Neck Surgery at Henry Ford Hospital in Detroit. Seidman, who is the chair-elect of the board of governors for the American Assn. of Otolaryngology, owns a small stake — less than 5% — in Arches Natural Products, the company that produces Tinnitus Relief Formula.

Seidman says he recommended Tinnitus Relief Formula to his patients long before he had any connection with the company. By his estimation, about four or five patients out of 100 who try the product say that their ringing disappears completely. More than half want to keep taking the formula even though they aren't sure how well it's working, if at all. He advises a four-month trial of the tinnitus combo pack. "If it isn't helping by then, you should stop spending your money. It's probably not going to work."

William Martin, professor of otolaryngology-head neck surgery and director of the Tinnitus Clinic at the Oregon Health & Science University in Portland, says that there are still huge gaps in the science surrounding tinnitus. But for now, he says, there's no good evidence that any supplement helps. Martin notes that tinnitus supplements tend to come with the disclaimer that they are "not intended to diagnose, treat, cure or prevent any disease."

"I think that says it all," Martin says.

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